Healthcare Provider Details

I. General information

NPI: 1225995137
Provider Name (Legal Business Name): MONTECITO SPECIALTY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1187 COAST VILLAGE RD STE 1-747
MONTECITO CA
93108-2737
US

IV. Provider business mailing address

1187 COAST VILLAGE RD STE 1-747
MONTECITO CA
93108-2737
US

V. Phone/Fax

Practice location:
  • Phone: 805-881-8512
  • Fax:
Mailing address:
  • Phone: 805-881-8512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CARRIE ANDERSON
Title or Position: FNP
Credential: NURSE PRACTITIONER
Phone: 805-881-8512